Sunny L. Clark, NURSE PRACTITIONER

Primary specialty

School Nurse PractitionerTaxonomy code 363LS0200X

License

1171 Issued in CA

Practice address

50 Phelan Ave
Hc100
San Francisco, CA 94112-1821

Phone

(415) 239-3192

Fax

(415) 239-3193

NPI assigned

Feb 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Francisco Community College District

  • Community Health Clinic/Center
  • San Francisco, CA
  • NPI 1497945810
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184766461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PALO ALTO AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142121",
            "telephone_number": "415-452-5384",
            "fax_number": "415-239-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PHELAN AVE",
            "address_2": "HC100",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941121821",
            "telephone_number": "415-239-3192",
            "fax_number": "415-239-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SUNNY",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "CA",
            "license": "1171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN NP",
            "identifier": "208874  1171",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald A Clark, M.D.
• Stephanie Jane Clark, RN
• Steve Clark
• Steven Douglas Clark, PSYCHIATRIC TECH
• Suelynn Genevieve Clark, MSN, FNP
• Taylor Chapman Clark, M.D.
• Toure Chiwan Clark, MPH
• Alexander Linden Clarke, MBBS FANZCA
• Annette V. Clarke, PH.D.
• Genevieve Anastasia Clarke

• Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.